Michelle – I think steroid destroys all her immune systems and she may
not have enough of her own to fight against URIs – so watch out.. Dharma and
Naomi both got sicker as their URIs (green discharge) came back form their
nose and couldn't get rid of it and that was towards the end of their
illness – Lucy WILL need a good immune system to fight off – what she has if
she has FIP, extreme unbalance of good and bad immune systems.. as steroid
may kiil bad ones and may kill good ones too.. and they develop secondary
illness due to that and their body is not strong enough to fight against and
sometime that's what kill them, too..
------------------------------
*From:* [EMAIL PROTECTED] [mailto:
[EMAIL PROTECTED] *On Behalf Of [EMAIL PROTECTED]
*Sent:* Friday, February 02, 2007 7:42 AM
*To:* felvtalk@felineleukemia.org
*Subject:* what would you do?
So through yesterday Lucy continued to purr and eat and occasionally
slowly walk to the litterbox or another room. She is very fatigued, probably
from her anemia. Hideyo had said that giving the feline interferon every day
seemed to help Dharma feel better, so I gave Lucy the feline interferon for
the second day in a row yesterday afternoon. In the evening, she was much
more out of it. Still no fevers though. So at about 10 pm I gave her a
dexamethasone shot that I got from the vet. I was planning, if I thought she
definintely has fip (which is seeming more and more likely) to put her on
steroid shots to make her more comfortable. Well, this is the second time
she got a dex shot, the other time being Tuesday after getting some fluids
drained. Last night, like Tuesday, she got a fever about an hour after
getting the dex shot, and all the congestion came back to her nose.
Although it does not really make sense according to the vet, I am positive
now that the return of fevers and congestion comes from the dex shots. But,
like last time, when I got up in the early morning she was at the top of the
6 foot tall cat tree, and purring. She has been there all morning. She has
meowed a few times, which she normally did a lot while healthy, and purrs,
and has eaten a little, but generally looks the same as she did before
getting the additional feline interferon and dexamethasone, only at the top
of the cat tree rather than on a cat bed on the floor. Clearly she got some
burst of energy, but I think it is rather temporary.
So I am trying to decide, now, whether to switch her from oral
prednisolone to dexamathasone shots. I did read in the archives of one of
the FIP lists that a cat with presumptive dry FIP (all the signs and lab
work, but no tissue biopsy) was put on strong dexamethasone instead of pred
and after a couple of months went into remission and is still in remission 2
years later. And dex gives Lucy at least a small period of energy, clearly,
a few hours after getting the shot. And another potential upside is that if
it reduces her fip-induced inflammation more than the pred, it could give
the epogen more of a chance to work, as epogen apparently does not work well
if there is a lot of inflammation because inflammation causes sequestering
of iron, even when iron is added (I am giving pet tinic and folic acid). And
anemia may be what is likely to kill her first. Those are the potential
upsides of giving dexamethasone instead of pred.
Here are the downsides: She seems to get temporary fevers from the dex,
and she seems to feel pretty miserable while she has the fevers (and I need
to give her some fluids, which may increase her belly effusion, and put ice
on her, which she doe snot like). So far she had fever last night for a
couple of hours. Last time the fever came back the following afternoon, so I
will need to see if that happens today. Also, she looks a little bit
wired-- her expression. Then, she seems to get some of her URI symptoms
back from the dex, like some congestion in her nose. Finally, she is still
on clindamycin in case this is toxo. It is looking less and less like toxo,
but I can not find a way of telling for sure and sometimes the antibiotics
do not make a big difference for a few weeks. Even high doses of pred like
she was on is bad for treating toxo, but dex is the worst-- when lab
researchers induce toxo in animals to study it (horrible, I know), they
bring out the clinical symptoms (most animals do not actually get sick just
from being infected with toxo) by giving them dexamethasone. So giving dex
is a definite giving up on the abx doing anything. Also, Lucy is on feline
interferon, and it is unclear what being on dexamethasone would do to the
chances of the feline interferon helping her in any way, whether prolonging
life or just making her feel better. Feline interferon is normally given
with some prednisone, but lower dosage of pred than Lucy has been getting,
much less dexamethasone. They do not know why the feline interferon helps
sometimes with fip. In one theory it is anti-viral, which means that
increasing steroids would decrease its ability to work. In the other theory
it modulates the immune system and therefore controls inflammation when the
immune system is out of control like with fip, in which case steroids would
work in conjunction with it rather than against it. But all of the success
stories (of which there are only a few) of feline interferon curing fip or
giving long remissions have been with using it in conjunction with less pred
than Lucy was on. None with dex, though I do not think it has been tried
with dex.
So what would you do? Switch to dex or keep her on the pred? I have never
had a doubt before about this when I thought my cats were in their last
stages that it was the right thing to give heavy doses of steroid shots. It
has always clearly made them feel so much better, even, or perhaps
especially, with my cat Buddy who probably had dry FIP. But it is less
clear for me with Lucy, both because it is unclear if on the whole it makes
her feel better, and because it may work against some of the other meds she
is on (feline interferon and abx). Then again, it might help the epogen to
work. Without the dex, on 12.5 mg/day of prednisolone, Lucy was still
eating and still very purry and seemed comfortable, just incredibly
fatigued. Part of me feels like it is better to try to help her stay like
that, if possible, than give her something that brings on fever and
congestion, even with a small temporary surge of energy. But part of me
feels like, wow, she climbed to the top of a 6 foot tall cat tree-- how can
she not feel better?
Please let me know what you think I should do.
Thanks,
Michelle
